HomeMy WebLinkAbout1255 CYNTHIA LN; ; 75-103; Permitf'1U-*
,- f ELiqiRTCAL PERMIT APPLICATION*"
Applicant to complete numbered spaces only PhOFie 729-1181 ,Permit No
.LECAL
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ATTACHED SHEETI
" 'OWNER
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ulAIL ADDRESS
CONTRACTOR ,£• MAIL ADDRESS LICENSE NO ST ATE
>.:ANCHITECT OR DESIGNER
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MAIL ADDRESS LICENSE NO
CNGlNEERvr.:., ,~J,.'r. -*, '... ,^i< •> .-.f ~ ..-- ?i - - ' ";*'> ADDBBSS ,';,,! I » (J. I- .I- PHONE., . ... • / . , ^ ,., .* L , /i LICENSE NO .
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USE OF BUI LDINC i
8w*6lBS$ofwork-nw^nNEW fi*ADDITION DALTERATION D REPAIR
9 Descr.bework
SPECIAL CONDITIONS
PERMITTEES.:
ISSUANCE OF EACH PERMIT
M
O(
APPLICATION ACCEPTED BY .
/ /
PLANS CHECKED BY APPROVED FOR ISSUANCE BY
NEW CONSTRUCTION, FOR EACH
AMPERES OF MAIN SERVICE, SWITCH,
FUSE -OR BREAKER
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK QR CONSTRUC
TION AUTHORISED IS NOT? COMMENCED WITHIN 60 DAYS "OR IF
CONSTRUCTION OR WORK IS SUSPENDED
NEW SERVICE ON EXISTING BLDG
FOR EA AMPERE OF INCREASE
IN MAIN SERVICE, SWITCH, FUSE
OR BREAKER--•30.7 -?• -/.I
*,
-#.
120 DAYS AT ANY
ED OR ABANDONED FOR A
TIME AFTER WORK IS COMPERIOD OF
MENCEDI HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THISAPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECTALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THISTYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEDHEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOTPRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THEPROVISIONS OF AN.YKOTHER STATE OR'-LOSAL LAW REGULATINGCONSTRUCTION OR';T,HE PERFORMANCE OF CONSTRUCTION
V:
AUHOR i z ED' AGEN T -";
REMODEL, ALTERATION, NO CHANGE
IN SERVICE, FOR EA AMPERE OF
INCREASE
TEMP SERVICE UP TO AND INCLUD-
ING 200 AMP -,
TEMP SERVICE OVER 200 AMP
PER 100 - -
i GN AT.iinw o rgco.N TR'ACTOR^OR-AU^IJA.T'E l"/v":;v J
PERMIT FEE
SlCHATUMt OF OWNER (IF OWNEB BUILDER)E'
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK M O
INSPECTOR